Videolaryngoscope designs for tracheal intubation in adults: a systematic review with network meta‐analysis of randomised controlled trials
Authors' conclusion
We are moderately certain that the three designs of videolaryngoscopes enhance tracheal intubation effectiveness, safety and postoperative recovery compared with direct laryngoscopes.
Study context
- Population
- Adults (aged ≥16 years) requiring tracheal intubation under GA
- Participants
- 44,284 adults · 294 studies
- Comparison
- Channelled, Macintosh-blade and hyperangulated videolaryngoscopes and video stylets vs direct laryngoscopes
- Outcome
- Incidence of failed first tracheal intubation attempts
Pooled result
As reported in the abstract
Each group vs direct laryngoscopesOdds ratio (95% CrI)
Channelled bladesCrI; moderate certainty
0.37(0.27–0.50)
Macintosh bladesCrI; moderate certainty
0.45(0.31–0.64)
Hyperangulated videolaryngoscopesCrI; moderate certainty
0.51(0.39–0.68)
Video styletsCrI; low certainty; no significant difference
0.67(0.16–3.00)
Further pooled results
Failure at second and third attempts, difficult intubation, glottic view
- All three videolaryngoscope designs reduced failure across second and third attempts, decreased difficult intubation and improved glottic view vs direct laryngoscopes
Glottic view, videolaryngoscope designs compared
- Channelled- and hyperangulated-blade videolaryngoscopes significantly improved glottic view vs Macintosh-blade designs
Original publication
Videolaryngoscope designs for tracheal intubation in adults: a systematic review with network meta‐analysis of randomised controlled trials. Anaesthesia. Published 11 March 2025. doi:10.
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